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  • INTERNATIONAL FINANCIAL REPORT 2016

  • CONTENTS2 MSF PROGRAMMES AROUND THE WORLD

    4 ACTIVITIES AND ORGANISATION

    5 PRESIDENTS REPORT

    6 TREASURERS REPORT

    7 AUDITORS REPORT

    COMBINED FINANCIAL STATEMENTS 9 Statement of Financial Activities 10 Statement of Financial Position 11 Statement of Changes in Funds 12 Statement of Cash Flows

    NOTES TO THE FINANCIAL STATEMENTS 15 Basis of Reporting 17 Notes to the Statement of Financial Activities 23 Notes to the Statement of Financial Position 29 Ratios and Sectorial Information 35 Other Information

    38 FINANCES BY COUNTRY

    International Financial Report 2016 1

    CONTENTS

  • MSF PROGRAMMES AROUND THE WORLD

    IRAN

    TURKEY

    IRAQ

    GEORGIA

    UKRAINE

    BELARUS

    BULGARIA

    ARMENIA AZERBAIJAN

    LEBANON

    JORDAN

    GREECE

    ITALY

    FRANCE

    BELGIUMGERMANY

    AUSTRIA

    ALGERIA

    MAURITANIA

    SUDAN

    SOUTH SUDAN

    CENTRAL AFRICAN REPUBLIC

    DEMOCRATIC REPUBLIC OF

    CONGO

    ETHIOPIA

    KENYAUGANDA

    BURUNDIRWANDA

    MALAWI

    ZIMBABWE MADAGASCAR

    MOZAMBIQUE

    SWAZILAND

    SOUTH AFRICA

    BOLIVIA

    COLOMBIA

    ECUADOR

    EL SALVADOR

    VENEZUELA

    HAITI

    MEXICO

    HONDURAS

    SYRIA

    CHAD

    NIGERIA

    NIGER

    CAMEROON

    MALI

    BURKINA FASO

    GUINEA

    SENEGAL

    LIBERIA

    GUINEA-BISSAU

    SIERRA LEONE CTE DIVOIRE

    EGYPTLIBYA

    TUNISIA

    PALESTINE

    CONGO

    ANGOLA

    ZAMBIA

    TANZANIA

    YEMENERITREA

    SOMALIA

    2 Mdecins Sans Frontires

    MSF PROGRAMMES AROUND THE WORLD

  • Countries in blue have a total expenditure of less than 500,000 euros and are included in other countries

    39 AFGHANISTAN

    39 ANGOLA

    40 ARMENIA

    40 BANGLADESH

    41 BELARUS

    41 BELGIUM

    42 BOLIVIA

    42 BURUNDI

    43 CAMBODIA

    43 CAMEROON

    44 CENTRAL AFRICAN REPUBLIC

    44 CHAD

    45 COLOMBIA

    45 CTE DIVOIRE

    46 DEMOCRATIC REPUBLIC OF CONGO

    46 EGYPT

    47 ETHIOPIA

    47 FRANCE

    48 GEORGIA

    48 GREECE

    49 GUINEA

    49 GUINEA-BISSAU

    50 HAITI

    50 HONDURAS

    51 INDIA

    51 INDONESIA

    52 IRAN

    52 IRAQ

    53 ITALY

    53 JORDAN

    54 KENYA

    54 KYRGYZSTAN

    55 LEBANON

    55 LIBERIA

    56 LIBYA

    56 MADAGASCAR

    57 MALAWI

    57 MALI

    58 MAURITANIA

    58 MEXICO

    59 MOZAMBIQUE

    59 MYANMAR

    60 NIGER

    60 NIGERIA

    61 PAKISTAN

    61 PALESTINE

    62 PAPUA NEW GUINEA

    62 PHILIPPINES

    63 RUSSIAN FEDERATION

    63 SIERRA LEONE

    64 SOMALIA

    64 SOUTH AFRICA

    65 SUDAN

    65 SOUTH SUDAN

    66 SWAZILAND

    66 SYRIA

    67 TAJIKISTAN

    67 TANZANIA

    68 TUNISIA

    68 TURKEY

    69 UGANDA

    69 UKRAINE

    70 UZBEKISTAN

    70 VENEZUELA

    71 YEMEN

    71 ZIMBABWE

    72 MEDITERRANEAN SEA OPERATIONS

    72 MIGRANT SUPPORT EAST EUROPE

    73 OTHER COUNTRIES

    73 TRANSVERSAL ACTIVITIES

    RUSSIAN FEDERATION

    CHINA

    BANGLADESH

    MYANMAR

    THAILAND

    CAMBODIA

    MALAYSIA

    AUSTRALIA

    INDONESIA

    PHILIPPINES

    PAPUA NEW GUINEA

    INDIA

    NEPALPAKISTAN

    UZBEKISTANKYRGYZSTAN

    TAJIKISTAN

    AFGHANISTAN

    International Financial Report 2016 3

  • ACTIVITIES AND ORGANISATIONMdecins Sans Frontires (MSF) is an international, independent, medical humanitarian organisation. We deliver emergency aid to people affected by armed conflict, epidemics, natural disasters and exclusion from healthcare.

    This report is presented along with the financial statements of the organisation for the year ended 31 December 2016. These financial statements are a means of transparency and accountability, illustrating the financial situation of the movement as a whole. They have been prepared in accordance with the accounting policies set out in Note 1.6 to the Financial Statements.

    OBJECTIVES AND POLICIES MSF offers humanitarian assistance to people based on need and irrespective of race, religion, gender or political affiliation. We work to save lives, alleviate suffering and restore dignity. Our actions are guided by medical ethics and the principles of neutrality and impartiality.

    In order to be able to access and assist people in need, our operational policies must be scrupulously independent of governments, as well as religious and economic powers. We conduct our own assessments, manage our projects directly and monitor the impact of our assistance. We do not accept funds from governments or other parties who are directly involved in the conflicts to which MSF is responding. We rely on the generosity of private individuals for the majority of our funding.

    In 2016, near 7,700 health professionals, logistics specialists and administrative staff of all nationalities left on field assignments to join more than 32,000 locally hired staff working in medical programmes in over 71 countries.

    MSF is constantly seeking to improve the quality, relevance and extent of its assistance, and is dedicated to the pursuit of innovation. The Access Campaign supports our field programmes by pushing for improved access to existing medicines, diagnostics and vaccines, and the development of better, more appropriate medicines. MSF also funds research into the development of drugs for neglected diseases.

    ORGANISATIONAL STRUCTUREMSF is a non-profit, self-governed organisation. Founded in Paris, France in 1971, MSF today is a worldwide movement of associations, with offices all over the world. Specialised organisations called satellites are in charge of specific activities such as humanitarian relief supplies, epidemiological and medical research studies, and research on humanitarian and social action.

    In 2011 MSFs international governance structure was reformed. MSF International was registered in Switzerland and, in December 2011, the first annual MSF International General Assembly (IGA) was held. Since then, the IGA has been held in June. The IGA comprises two representatives of each MSF association, two representatives elected by the individual members of MSF International, and the International President. The IGA is the highest authority of MSF International and is responsible for safeguarding MSFs medical humanitarian mission, and providing strategic orientation to all MSF entities.

    The International Board acts on behalf of and is accountable to the IGA. It is made up of representatives of MSFs operational directorates as well as a group elected by the IGA, and is chaired by the International President. The International Board prepares and presents the international combined Financial Statements to the OGA for approval.

    For the year ended 31 December 2016

    THE CHARTER OF MDECINS SANS FRONTIRESMdecins Sans Frontires is a private international association. The association is made up mainly of doctors and health sector workers and is also open to all other professions that might help in achieving its aims. All of its members agree to honour the following principles:

    Mdecins Sans Frontires provides assistance to populations in distress, to victims of natural or man-made disasters and to victims of armed conflict. They do so irrespective of race, religion, creed or political convictions.

    Mdecins Sans Frontires observes neutrality and impartiality in the name of universal medical ethics and the right to humanitarian assistance and claims full and unhindered freedom in the exercise of its functions.

    Members undertake to respect their professional code of ethics and to maintain complete independence from all political, economic or religious powers.

    As volunteers, members understand the risks and dangers of the missions they carry out and make no claim for themselves or their assigns for any form of compensation other than that which the association might be able to afford them.

    ALL THOSE WORKING WITH MSF AGREE TO ABIDE BY THE PRINCIPLES OF THE CHARTER OF MSF AS FOLLOWS:

    4 Mdecins Sans Frontires

    ACTIVITIES AND ORGANISATION

  • PRESIDENTS REPORTAlmost one-third of Mdecins Sans Frontires (MSF) projects in 2016 were dedicated to providing assistance to populations caught in wars, such as in Yemen, South Sudan, Afghanistan, Iraq, Nigeria and Syria. MSF also provided assistance to people on the move, fleeing repression, poverty or violence, and in many cases subject to new forms of violence, exploitation or danger as countries closed options for safe and legal routes. Our teams responded to other emergencies caused by epidemics and natural disasters and provided care and improved treatment for patients with diseases such as tuberculosis (TB) and HIV.

    People in conflictIn many conflict zones, civilians and civilian infrastructure including medical facilities came under indiscriminate or targeted attacks. Millions of people had to flee their homes, sometimes multiple times. Our teams provided assistance to those caught in conflict and fleeing. They cared for pregnant women and newborns, treated the wounded and people with medical emergencies, managed chronic illnesses and responded to disease outbreaks, notably through vaccination campaigns. MSF also worked to meet other vital needs, such as for drinking water and essential relief items. From Lebanon to Tanzania, MSF teams mobilised to assist hundreds of thousands of people who have fled violence and conflict to other countries in search of safety.

    In Nigeria, the armed conflict between Boko Haram and the Nigerian military displaced an estimated 1.8 million people in Borno State alone, with many communities cut off from the rest of the country for extended periods of time due to the conflict. In June, with only limited access due to widespread insecurity, MSF teams discovered shocking situations in villages such as Bama, where two out of 10 children under five were at risk of death due to malnutrition. Thousands of people regrouped in different villages were entirely reliant on aid. By the end of the year, the humanitarian situation had improved in areas that were still accessible. However, the widespread insecurity and military restrictions presented a significant challenge to MSF and other humanitarian actors: the number of people in need of lifesaving assistance in inaccessible areas is unknown.

    The armed conflict in Nigeria took on a regional dimension in the Lake Chad Basin, expanding across borders to Cameroon, Chad and Niger, with direct consequences for civilian populations. The crisis aggravated an already dire situation in a region suffering from poverty, food insecurity, recurring outbreaks of disease and almost non-existent health systems. MSF teams stepped up medical and humanitarian assistance in Chad, Cameroon and Niger for people fleeing Nigeria, as well as for local and displaced populations affected by the crisis.

    In South Sudan in July, intense fighting erupted between government and opposition forces in the capital, Juba. MSF opened clinics to provide emergency treatment for patients with gunshot wounds and injuries, as well as ongoing healthcare for conditions such as malnutrition, malaria and diarrhoea. Between August and December, we intensified our response to help South Sudanese refugees as the number of people fleeing violence increased, with hundreds of thousands arriving in Uganda, as well as Ethiopia and Sudan.

    In areas hit by violence, adapted solutions have to be found. In South Sudan, to ensure continuity of care during instability for patients receiving HIV antiretroviral treatment, three-month emergency patient kits were prepared and distributed in the event of imminent displacement.

    In Syria, MSF medical activities continued to be significantly constrained due to insecurity in opposition areas and lack of authorisation by the Syrian government. MSF operated six medical structures in northern Syria in 2016. In inaccessible zones, such as besieged areas, our teams provided distance support to medical networks inside the country, through training, technical support and donations to medical facilities. This remains an extraordinary approach for MSF, made necessary by peoples extreme level of need and suffering and our lack of direct access. The level of violence, and need, and lack of assistance led to sustained public communications by MSF through the testimonies of Syrian medical staff we supported, particularly in East Aleppo city and in besieged areas around Damascus.

    Following the closure of the border between Syria and Jordan in June, around 75,000 Syrians were left stranded in the Berm/Rukban area. MSF teams and other aid actors were no longer able to reach the population. The border closures also prevented people from seeking assistance and protection outside Syria, a situation that is emblematic of a growing, pervasive reality across war zones, particularly in Syria.

    In Yemen, indiscriminate attacks against civilians and civilian infrastructure had a devastating impact on a country that was already one of the poorest in the region. To address the lack of healthcare and treat the increasing number of war victims, MSF scaled up its activities, making the response in Yemen our largest in the Middle East in 2016. MSF teams directly provided healthcare to patients in 12 hospitals and supported at least 18 other facilities. On 15 August, an airstrike on Abs hospital in northern Yemen killed 19 people, including an MSF staff member, and wounded 24. MSF withdrew its staff from six hospitals in the north of the country following the airstrike, but continued to support the facilities. MSF resumed activities in northern Yemen in November 2016.

    In May, the United Nations Security Council unanimously adopted Resolution 2286, condemning attacks on medical facilities and pledging to protect staff and patients in conflict settings. Yet airstrikes and shelling against health facilities continued, often by military coalitions acting with the direct or indirect involvement of Security Council members France, Russia, UK and USA. In 2016, 34 different health structures managed or supported by MSF were attacked in this way in Syria and Yemen.

    Treacherous transit routesThe number of people crossing by sea to Italy increased from 153,000 in 2015 to over 180,000 in 2016. At least 5,000 men, women and children died while attempting the journey. MSF teams aboard three search and rescue vessels rescued

    Dr Joanne Liu International President

    Jrme Oberreit Secretary General

    21,600 people from boats in distress in the Mediterranean. Our teams also recovered the bodies of people who drowned or were asphyxiated, crushed by the weight of hundreds of others.

    With no safe and legal alternatives to reach Europe, almost all those rescued passed through Libya in search of assistance and protection. They described horrific suffering at the hands of smugglers, armed groups and individuals who exploited the desperation of those fleeing conflict, persecution or poverty.

    In June, three months after the signing of the EU-Turkey deal, MSF announced it would no longer accept funds from the EU or EU Member States, in opposition to their damaging deterrence policies and continued attempts to push people and their suffering away from European shores.

    In July, MSF began to run clinics in and around Tripoli, the Libyan capital, at some of the detention facilities established to lock up people on the move. Our teams witnessed catastrophic and inhumane living conditions.

    In Central America, people from Honduras, Guatemala and El Salvador fleeing violence in their home countries were revictimised during their journey through Mexico to the United States. Of all MSF medical consultations in the migrant/refugee programmes in Mexico, a qu...

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